Is it all bleak? A systematic review of factors contributing to relationship change in dementia

2018 ◽  
Vol 30 (11) ◽  
pp. 1619-1637 ◽  
Author(s):  
Erin R. Conway ◽  
Brittany Watson ◽  
Gemma Tatangelo ◽  
Marita McCabe
Keyword(s):  
Systematic Review ◽  
Relationship Quality ◽  
Family Relationships ◽  
Meta Analysis ◽  
Role Identity ◽  
Community Dwelling ◽  
The People ◽  
People With Dementia ◽  
Relationship Change

ABSTRACTBackground:The care of community-dwelling people with dementia often occurs in the context of pre-existing family relationships. The presence of dementia can result in changes to the quality of those relationships. The purpose of this systematic review is to identify factors that enhance or challenge the quality of spousal or offspring relationships in the context of dementia.Methods:Both qualitative and quantitative studies were included in a systematic review of the literature. Thematic analysis of results was conducted that examined factors related to the relationship quality of community dwelling people with dementia and their spousal or offspring carer. Meta-analysis was not possible due to the heterogeneity of the included studies.Results:Four themes were extracted from seven qualitative studies: connection to the carer role; identity of the people with dementia; current efforts to maintain relationship connection; and the dyads response to dementia. Each of these four themes incorporated positive and negative facets that impacted on relationship quality. An analysis of nine quantitative and one mixed methods studies identified four domains: influence of dementia characteristics; connection within the dyad; relationship response to stress and carer burden; and carer demographic factors.Conclusions:The findings of this review highlight relationship factors that are important for supporting relationship quality for the people with dementia and the carer individually, as well as for the dyad together. These findings extend an existing framework of relationship quality in dementia. Implications for interventions to enhance relationship quality in the dementia context are discussed.

scholarly journals Living well with dementia: a systematic review and correlational meta-analysis of factors associated with quality of life, well-being and life satisfaction in people with dementia

2018 ◽  
Vol 48 (13) ◽  
pp. 2130-2139 ◽  
Author(s):  
Anthony Martyr ◽  
Sharon M. Nelis ◽  
Catherine Quinn ◽  
Yu-Tzu Wu ◽  
Ruth A. Lamont ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Life Satisfaction ◽  
Social Engagement ◽  
Meta Analysis ◽  
Well Being ◽  
Factors Associated ◽  
Living Well ◽  
People With Dementia

AbstractCurrent policy emphasises the importance of ‘living well’ with dementia, but there has been no comprehensive synthesis of the factors related to quality of life (QoL), subjective well-being or life satisfaction in people with dementia. We examined the available evidence in a systematic review and meta-analysis. We searched electronic databases until 7 January 2016 for observational studies investigating factors associated with QoL, well-being and life satisfaction in people with dementia. Articles had to provide quantitative data and include ⩾75% people with dementia of any type or severity. We included 198 QoL studies taken from 272 articles in the meta-analysis. The analysis focused on 43 factors with sufficient data, relating to 37639 people with dementia. Generally, these factors were significantly associated with QoL, but effect sizes were often small (0.1–0.29) or negligible (<0.09). Factors reflecting relationships, social engagement and functional ability were associated with better QoL. Factors indicative of poorer physical and mental health (including depression and other neuropsychiatric symptoms) and poorer carer well-being were associated with poorer QoL. Longitudinal evidence about predictors of QoL was limited. There was a considerable between-study heterogeneity. The pattern of numerous predominantly small associations with QoL suggests a need to reconsider approaches to understanding and assessing living well with dementia.

scholarly journals Home-Based Physical Activity Programs for People With Dementia: Systematic Review and Meta-Analysis

2019 ◽  
Vol 60 (8) ◽  
pp. e600-e608 ◽  
Author(s):  
Sara Isabel Lebre de Almeida ◽  
Madalena Gomes da Silva ◽  
Alda Sofia Pires de Dias Marques
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Meta Analysis ◽  
Functional Reach ◽  
People With Dementia ◽  
Home Based ◽  
Functional Reach Test

Abstract Background and Objectives Physical activity has the potential to improve health outcomes in people with dementia, namely when living at home. However, the knowledge about home-based physical activity for this population is scarce. Thus, we aim to identify and synthesize the effects of home-based physical activity for people with dementia. Research Design and Methods A systematic review was conducted. Quality of studies was assessed using the Delphi List. Effect sizes (ES) were calculated with MetaXL 2.0. A meta-analysis was conducted for the Mini-Mental Status Examination (MMSE), Neuropsychiatric Inventory (NPI), Cornell Scale for Depression in Dementia, Alzheimer’s Disease Cooperative Study Group Activities of Daily Living Scale (ADCS-ADL), Functional Reach test, Timed Up and Go (TUG) test, Short Physical Performance Battery, Dementia Quality of Life, NPI Caregivers subscale and Zarit Burden Interview (ZBI). Results Sixteen randomized controlled trials were included. Most were of high quality and published after 2015. A large heterogeneity of interventions was found. Meta-analysis showed significant results in MMSE (ES = 0.71, 95% CI 0.43, 0.99), NPI (ES = −0.37, 95% CI −0.57, −0.17), ADCS-ADL (ES = 0.80, 95% CI 0.53, 1.07), Functional Reach test (ES = 2.24, 95% CI 1.80, 2.68), TUG test (ES = −2.40, 95% CI −2.84, −1.96), NPI Caregivers subscale (ES = −0.63, 95% CI −0.94, −0.32), and ZBI (ES = −0.45, 95% CI −0.77, −0.13). Few minor adverse events and high adherence to intervention were found. Discussion and Implications Home-based physical activity seems safe and effective in delaying cognitive function decline and improving changes in behavioral and psychological symptoms of dementia, activities of daily living, health-related physical fitness, and carer’s burden in people with dementia living at home.

scholarly journals Psychological treatments for depression and anxiety in dementia and mild cognitive impairment: Systematic review and meta-analysis

2015 ◽  
Vol 207 (4) ◽  
pp. 293-298 ◽  
Author(s):  
Vasiliki Orgeta ◽  
Afifa Qazi ◽  
Aimee Spector ◽  
Martin Orrell
Keyword(s):  
Systematic Review ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Psychological Treatment ◽  
Meta Analysis ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Psychological Treatments ◽  
People With Dementia

BackgroundAnxiety and depression are common in people with dementia and mild cognitive impairment (MCI), but there is uncertainty about the effectiveness of both pharmacological and psychological therapies.AimsTo evaluate the evidence of effectiveness of psychological treatments in treating depression and anxiety in people with dementia and MCI.MethodWe carried out a systematic review and meta-analysis of randomised controlled trials (RCTs) of psychological treatment versus usual care in people with dementia and MCI. Primary outcomes were symptoms of anxiety and depression. Secondary outcomes were quality of life, ability to perform daily activities, neuropsychiatric symptoms, cognition and caregivers' self-rated depressive symptoms.ResultsWe included six RCTs, involving 439 participants with dementia, which used cognitive–behavioural therapy, interpersonal therapy, counselling or multimodal interventions including a specific psychological therapy. We found beneficial effects for both depression and anxiety. Overall, the quality of the evidence was moderate for depression and low for anxiety, due to the methodological limitations of the studies we identified and the limited number of trials.ConclusionsThe evidence from six RCTs suggests that psychological treatments are effective in reducing symptoms of depression and anxiety for people with dementia. There is a need for high-quality, multicentre trials including standardised, well-defined interventions.Declarations of interestA.Q., A.S. and M.O. are investigators in one of the included studies.

scholarly journals Degree of personalisation in tailored activities and its effect on behavioural and psychological symptoms and quality of life among people with dementia: a systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e048917
Author(s):  
Shiyu Lu ◽  
Anna Y Zhang ◽  
Tianyin Liu ◽  
Jacky C P Choy ◽  
Maggie S L Ma ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Psychological Symptoms ◽  
Meta Analysis ◽  
People With Dementia ◽  
Behavioural And Psychological Symptoms ◽  
Moderate Effect ◽  
Mean Differences ◽  
High Level

ObjectivesTo understand and assess the degree of personalisation of tailored activities for people with dementia (PWD); and to estimate the magnitude of the effects of levels of personalisation on reducing behavioural and psychological symptoms of dementia (BPSD), improving quality of life (QoL) and level of engagement.DesignSystematic review with meta-analysis.Data sourcesProQuest, PubMed, Ovid, Cochrane Library, Web of Science and CINAHL were searched from the start of indexing to May 2020.Eligibility criteriaWe included randomised controlled trials and quasi-experimental studies assessing the effects of tailored activities for people aged 60 years or older with dementia or cognitive impairment on the outcomes of BPSD, QoL, depression and level of engagement with control groups.Data extraction and synthesisTwo researchers screened studies, extracted data and assessed risks of bias. A rating scheme to assess the degree of personalisation of tailored activities was developed to classify tailored activities into high/medium/low groups. Effect sizes were expressed using standardised mean differences at 95% Confidence Interval (CI). Subgroup analyses were conducted to assess whether the degree of personalisation of tailored activities affected outcomes of interest.ResultsThirty-five studies covering 2390 participants from 16 countries/regions were identified. Studies with a high-level of personalisation interventions (n=8) had a significant and moderate effect on reducing BPSD (standardised mean differences, SMD=−0.52, p<0.05), followed by medium (n=6; SMD=−0.38, p=0.071) and low-level personalisation interventions (n=6; SMD=−0.15, p=0.076). Tailored activities with a high-level of personalisation had a moderate effect size on improving QoL (n=5; SMD=0.52, p<0.05), followed by a medium level (n=3; SMD=0.41, p<0.05) of personalisation.ConclusionsTo develop high-level tailored activities to reduce BPSD and improve QoL among PWD, we recommend applying comprehensive assessments to identify and address two or more PWD characteristics in designed tailored activities and allow modification of interventions to respond to changing PWD needs/circumstances.PROSPERO registration numberCRD42020168556.

Effects of Mindfulness-Based Interventions on Depressive Symptoms, Anxiety, Stress, and Quality of Life in Family Caregivers of Persons Living with Dementia: A Systematic Review and Meta-analysis

2021 ◽  
pp. 016402752110434
Author(s):  
Areum Han
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Depressive Symptoms ◽  
Family Caregivers ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Fixed Effects Model ◽  
Eligibility Criteria ◽  
People With Dementia

Objective: This systematic review and meta-analysis examined effects of mindfulness-based interventions (MBIs) on depressive symptoms, anxiety, stress, and quality of life in family caregivers of people with dementia. Methods: A comprehensive search was conducted within the PubMed, CINAHL, PsycINFO, and SCOPUS databases to identify relevant randomized controlled trials (RCTs). Depending on I2 statistic values for heterogeneity, either a random effects model or fixed effects model was used. Subgroup analyses were conducted according to the types of control groups and MBIs. Results: 15 RCTs met the eligibility criteria. Meta-analyses showed medium to large effects of MBIs on depressive symptoms, anxiety, stress, and quality of life at the immediate posttest. Small to large effects of MBIs were found at follow-up. Conclusions: Future high-quality studies involving different types of MBIs and delivery modes are needed to better understand effects of MBIs on family caregivers of people with dementia and examine effective intervention features.

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